Perinatal And Postnatal Depression: A Common But Often Hidden Problem.

Megon Champion
Apr 7
8 min read

Perinatal (prenatal) Depression affects 1 in 7 women, and Postnatal Depression affects 1 in 10 women. And in an alarming statistic, women in South Africa are 3 to 4 times more likely to experience perinatal depression than their worldwide counterparts. However, these severe conditions are often not discussed with expectant mothers, nor are they given the resources to cope.

If you feel that you want to harm yourself, the people around you or your baby. Or, if you believe your partner or family member may have these thoughts, contact emergency services or click here for emergency numbers.

How is Perinatal and Postnatal depression different from the “Baby Blues”?

“Baby Blues” are usually milder symptoms of depression brought on by the fatigue and hormone changes of having a baby. The most important difference is that they usually only last about two weeks, and the symptoms go away without any treatment.

What Is Perinatal Depression?

Perinatal or Prenatal Depression is depression that occurs during pregnancy. It causes ongoing sadness or extreme sadness and causes you to withdraw from life.

Who Is At Risk of Perinatal Depression?

Anybody is at risk, and it is good to remember that it is nobody's fault if they get this form of depression. However, there is a higher risk if there is a family history of:

Mood disorders and postnatal depression.
Mental illness such as obsessive-compulsive disorder (OCD).
Anxiety disorders.
Panic disorders.

Perinatal Depression is also more common in women who are:

Carrying multiple babies.
Carrying a child with special needs or health problems.
Are dealing with stressful life events outside of the pregnancy such as divorce, job loss, etc.
Having an unplanned pregnancy.
Do not have family or partner support during the pregnancy.
Had trouble getting pregnant due to infertility.

What Causes Perinatal Depression?

Many factors can lead to getting Perinatal Depression, the main one being a history or family history of mood disorders. Changes in hormones due to pregnancy can also affect the chemicals in the brain, causing an imbalance which can also lead to depression.

And outside stressors such as changes to a woman's physical body, leading to pregnancy discomforts or changes to financial situations or worries about taking on new responsibilities can also lead to depression.

What Are The Symptoms Of Perinatal Depression?

The symptoms of Perinatal Depression can overlap with normal pregnancy symptoms; however, they are more severe and last for longer periods:

Changes in appetite and unexplained weight loss or gain.
Decreased interest in activities you once enjoyed. Withdrawal from family, friends or social interactions.
Anxiety, excessive worry or intrusive thoughts.
Fatigue, sleeping more than usual, difficulty getting to sleep or insomnia.
Feelings of sadness, hopelessness, numbness, “emptiness”, or guilt.
Irritability, excessive crying or other mood changes or mood swings’
Difficulty connecting with your partner.
Physical symptoms that don’t result from a health condition or other cause. These may include headaches, muscle aches and gastrointestinal (GI) problems.
Problems concentrating, remembering things, reasoning or making decisions.
In severe cases, women with this disorder have thoughts about harming themselves or the developing fetus.

Diagnosis and Treatment.

Getting the correct diagnosis and treatment early is important as this means you will be able to get the support you need. It also means you will be able to take better care of yourself and your baby. Further, it means you will have a higher chance of bonding with your baby when it is born, which can lower your chance of Postnatal Depression.

Diagnosis.

To get a diagnosis, reach out to your healthcare provider. This could be your GP or OBGYN. They will go through your symptoms with you and then will recommend that you either go to a Psychiatrist or Psychologist for further assessment and treatment.

Treatment.

Four main types of treatment can be used to help:

Medication: to treat depression. Your health care team will go through which ones are safe to use during pregnancy and breastfeeding.
Psychotherapy (talk therapy): which allows you to talk through your emotions and develop ways to cope.
Cognitive behavioral therapy (CBT): a type of therapy that helps you think about your concerns and behaviors in a different way. Over time, you develop new thinking patterns. You’ll discover how to react to certain situations more positively.
Interpersonal therapy (IPT): allows you to improve the way you interact with others. It also helps you develop relationships and gain support from social groups.

Management.

Finally, there are some ways you can manage Perinatal Depression alongside your treatment:

Making health a priority: Get plenty of exercise during pregnancy. Focus on good nutrition, take prenatal vitamins and try to get enough sleep. Quit smoking and avoid alcohol since these are dangerous for both you and the developing fetus. Drinking alcohol while pregnant can cause fetal alcohol syndrome. Better physical health often goes hand-in-hand with improved mental health.
Preparing for your baby: Keep up with your appointments for prenatal care. Learn about fetal growth and milestones, and take time to get ready for your baby’s arrival. You’ll feel better knowing you’re prepared for childbirth and beyond.
Finding a supportive network: Connecting with other expecting parents allows you to share your concerns. You’ll learn from people who know what you’re experiencing. Call your local hospital and ask if they can recommend a support group or other resources.
Staying active: Make it a point to spend time with friends or go out with your partner. Interacting with others and getting out of the house can have a major impact on your mood.
Try meditation: If you’re feeling lots of stress or anxiety, try yoga, meditation and breathing exercises.

What is Postnatal Depression?

This is depression that occurs after giving birth. It usually occurs within the first six weeks of giving birth but can occur anywhere from birth to 12 months after giving birth. It is a severe form of depression and can include psychosis.

Who Is At Risk Of Postnatal Depression?

Much like Perinatal Depression, anyone is at risk of Postnatal Depression, and it is good to remember that it is nobody’s fault if you get diagnosed with this form of depression. However, there may be a higher risk if you have one of the following risk factors:

Having no close family or friends to support you.
Having a difficult relationship with your partner.
A history of mental health problems earlier in life, especially depression.
A history of depression during pregnancy.
Recent stressful events, such as job loss, etc.
Physical or psychological trauma, such as domestic violence.

What Causes Postnatal Depression?

Unfortunately, the causes of Postnatal Depression are not known. However, some known factors can contribute to causing it:

Emotional changes: adapting to parenthood is difficult. A new mother has to deal with the constant demands of her baby, a different dynamic in her relationships and the loss of independence. Such changes are hard at the best of times but are even more overwhelming when physically recovering from childbirth and coping with broken sleep.
Physical changes: even a relatively easy birth can be an overwhelming experience for a woman’s body. The sudden drop in pregnancy hormones also affects brain chemicals, which can lead to depression. Broken sleep and exhaustion can also contribute to depression.
Social changes: society puts lots of demands and expectations on a new mother, which a woman may feel she needs to live up to. She may find herself less able to keep up contact with her friends and workmates. Adapting to living on one wage may also be difficult.

What Are The Symptoms Of Postnatal Depression?

The symptoms of Postnatal Depression can be similar to baby blues, however, they are longer and more severe:

A persistent feeling of sadness and low mood.
Problems with concentration and making decisions.
A lack of interest and enjoyment in the wider world.
Withdrawing from contact from other people especially family and friends.
A lack of energy and tiredness all the time.
Finding it difficult to care for yourself and your baby.
Finding it difficult to sleep at night and feeling tired during the day.
Frightening thoughts, especially about your baby - this is known as Postnatal Psychosis.

Diagnosis And Treatment?

Much like Perinatal Depression, getting the correct diagnosis and treatment is important. With the correct treatment, it means you can get the support you need which allows you to care for yourself and your baby.

Diagnosis.

Treatment.

Four main types of treatment can be used to help:

Medication: to treat depression. Your health care team will go through which ones are safe to use during pregnancy and breastfeeding.
Psychotherapy (talk therapy): which allows you to talk through your emotions and develop ways to cope.
Cognitive behavioral therapy (CBT): a type of therapy that helps you think about your concerns and behaviors in a different way. Over time, you develop new thinking patterns. You’ll discover how to react to certain situations more positively.
Interpersonal therapy (IPT): allows you to improve the way you interact with others. It also helps you develop relationships and gain support from social groups.

Management.

There are some ways that you can manage to cope with Postnatal Depression alongside your treatment:

Talking to your partner, friends and family: try to help them understand how you're feeling and what they can do to support you.
Eating regular, healthy meals and not going for long periods without eating.
Try not to be a "supermom": accept help from others when it's offered and ask your loved ones if they can help look after the baby and do tasks such as housework, cooking and shopping.
Exercising regularly to boost your mood.
Making time for yourself: try to do activities that you find relaxing and enjoyable, such as going for a walk, listening to music, reading a book or having a warm bath.
Resting when you can: although it can be difficult when you're looking after a baby, try to sleep whenever you get the chance, follow good sleeping habits and ask your partner to help with the night-time work.
Not drinking alcohol or taking drugs, as this can make you feel worse.

Postnatal Psychosis.

Postnatal (or postpartum) Psychosis is a rare condition that usually occurs within the first week after delivery. Its symptoms include:

Making attempts to harm yourself or your baby.
Feeling confused and lost.
Feeling paranoid.
Having obsessive thoughts about your baby.
Having too much energy and feeling upset.
Hallucinating and having delusions.
Having sleep problems.

Treatment should be immediate and is the same as that for Postnatal Depression. However, if that doesn't work, Electroconvulsive Therapy (ECT) may be recommended by your doctor as a last resort.

If you feel that you want to harm yourself, the people around you or your baby. Or, if you believe your partner or family member may be having these thoughts, contact emergency services or click here for emergency numbers.

Postnatal Depression In Partners.

Postnatal Depression can be found in partners, too. Studies have found that 1 in 10 fathers can experience Postnatal Depression.

Risk factors.

Risk factors for partners can include:

Older age.
Poor physical health.
First-time parent.
History of mental health problems.
Small circle of friends.
Quality of relationship with partner.
Limited social interaction and support.
Concurrent stressful life events.
Limited education.

Treatment.

Treatment is the same as the treatment given to the mother.

Conclusion.

Perinatal and Postnatal Depression are common pregnancy issues. Therefore, nobody should feel embarrassed should they suffer from either condition. Nor should they feel like they shouldn’t ask for help if they are diagnosed with either condition.